Song W L, Wu J F
Department of Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Yi Xue Za Zhi. 2021 May 11;101(17):1206-1209. doi: 10.3760/cma.j.cn112137-20210107-00045.
Sepsis is a common cause of death in intensive care unit. Some retrospective studies had shown the combination of hydrocortisone, ascorbic acid and thiamine (HAT therapy) could lower mortality rate of patients with sepsis or septic shock. Recently, multiple randomized controlled trials(RCTs) related to the efficacy of combination therapy don't reach a consensus. Though one meta-analysis indicated beneficial effect of HAT regimen on decreasing mortality rate of patients with sepsis or septic shock, improving SOFA score and reducing use of vasopressor. However, controversy still exist in the target population, timing, dose and duration of HAT regimen. Thus, the optimized RCTs are needed to provide more definitive evidence.
脓毒症是重症监护病房常见的死亡原因。一些回顾性研究表明，氢化可的松、维生素C和硫胺素联合使用（HAT疗法）可降低脓毒症或脓毒性休克患者的死亡率。最近，多项关于联合治疗疗效的随机对照试验（RCT）尚未达成共识。尽管一项荟萃分析表明HAT方案对降低脓毒症或脓毒性休克患者的死亡率、改善序贯器官衰竭评估（SOFA）评分及减少血管升压药的使用有有益作用。然而，HAT方案的目标人群、时机、剂量和疗程仍存在争议。因此，需要开展优化的随机对照试验以提供更确凿的证据。
